Answer: To increase the good cholesterol, our first recommendation is lifestyle, in other words lose some weight, keep that weight off, get physically active. That's really the lifestyle change that is best for changing HDL cholesterol.

When we think about drug therapy, there's a lot of drugs in development here, but nothing has really come in and hit a home run yet. When the clinician decides to treat the HDL cholesterol, let's say it's low, and he or she wants to raise that level, probably the best choice is niacin. Niacin raises the HDL cholesterol much more convincingly then any of the other choices.

Now the statin drugs and the fibrates both have a modest effect on HDL, maybe a five to ten percent increase, but that increase may or may not be beneficial. We're really not sure yet whether raising HDL cholesterol independently of lowering LDL cholesterol reduces the risk for cardiovascular disease and stroke.

So back to the point, the point is, niacin is probably the drug of choice to raise HDL cholesterol, and you need to work with your physician to determine whether you're a candidate for niacin therapy.